The South Dakota House of Representatives will vote on a bill aimed at changing the legality of certain medical treatments for transgender individuals under the age of 16 Wednesday, Jan. 29, 2020 at the capitol building in Pierre.

House Bill 1057, also called the Vulnerable Child Protection Act, was introduced by Rep. Fred Deutsch, a republican representing district four (this includes Deuel and Grant counties as well as portions of Brookings and Codington counties). It was heard by the House Committee on State Affairs Jan. 22 and passed with a vote of 8-5.

Sections two and three of HB 1057 directly restrict the treatment of transgender youth in South Dakota statute.

The bill states that a medical professional will be found guilty of a Class 1 misdemeanor for providing transgender youth, age 15 and under, with reassignment surgery or hormone therapy used for either suppressing puberty or transitioning to the individuals’ gender.

The bill also prohibits the removal of “any otherwise healthy or nondiseased body part or tissue.”

Medical professionals treating intersex patients or individuals with sexual development disorders are exempt from these restrictions.

Receiving these treatments is not a decision made entirely by the individual under the age of 16.

Currently, South Dakota codified law 20-9-4 requires the consent of a parent or guardian for any treatment of a minor outside of a life-threatening emergency situation, a category in which hormone suppression and reassignment surgery do not apply.

HB 1057 bars individuals and their families from making decisions they feel are in their best interest regarding treatment options.

Furthermore, if a patient under the age of 16 and the parent or guardian of the patient give consent to receiving hormone therapy, the medical professional responsible for prescribing receives a Class 1 misdemeanor.

According to South Dakota codified, the punishment for a Class 1 misdemeanor is one year of imprisonment in a county jail and up to a $2,000 fine.

The version of HB 1057 that the House of Representatives will be voting on has been amended three times from its original form.

The unamended bill prohibited any minor, including emancipated minors, from receiving medical assistance in the transition process.

South Dakota law currently does not require parental consent in order for emancipated or married minors to receive medical treatment.

Additionally, the original bill listed the penalty for medical professionals who do provide the treatments as a Class 4 felony.

A Class 4 felony in South Dakota equates to up to 10 years imprisonment and up to $20,000 in fines.

Other Class 4 felonies in the state of South Dakota include second-degree arson, second-degree robbery and second-degree manslaughter. Punishment for providing certain treatments for transgender youth was initially given more severe punishment than making a terrorist threat, incest or the sale of child pornography in the state of South Dakota.

The bill is highly controversial and receiving attention on all ends of the political spectrum.

The prime sponsor for the bill, Deutsch, is a new member of the South Dakota House of Representatives, representing portions of Brookings, Codington, Deuel and Grant counties. Aside from his position as a legislator, he works as a chiropractor.

HB 1057 is the only bill Deutsch has presented to the legislature so far in 2020.

The House Committee on State Affairs first heard testimony Jan. 22 in Pierre. Deutsch spoke first to give information about the intent behind the bill.

Deutsch referred to this bill as a “pause button” for children under the age of 16.

“We want to give children the time to simply grow up,” Deutsch said. “We don’t want them taking drugs. We don’t want them to take puberty blockers and cross sex hormones. We want to move them to the professionals that will help them.”

Another argument made by Deutsch as to why he brought the bill forward is that the procedures described in HB 1057 are given as a result of the patients’ feelings.

“There’s no blood test. There’s no brain scan, nor any objective medical tests to detect it. It’s feelings,” Deutsch said. “And as you all know, feelings change. Especially in children.”

Deutsch also introduced the testimony that would be speaking in favor of HB 1057 in the committee meeting.

“You’re going to hear testimony from victims, compelling testimony from doctors, from progressive feminists, including an attorney who formerly worked at the ACLU, from a mental health counselor, from a transgender adult, a former transgender teen and others,” Deutsch said describing the proponent testimony.

Of the nine recorded opponents for the bill, all but one gave testimony via Skype.

All committee meetings are audio recorded and made available on the South Dakota Legislature’s website; however, the audio provided from each Skype call is inaudible on the recording provided for HB 1057.

All testimony supporting the bill, aside from that of Dr. Glenn Ridder, was not properly recorded and therefore not available to the public.

Ridder is a family medicine specialist for Sanford Health. His testimony argued that many of these treatments are not reversible, could potentially sterilize transgender youth and that patients under 16 cannot give informed consent.

“Prepubescent children are not emotionally mature enough to understand the short or certainly long-term ill effects of this ideologic treatment,” Ridder said. “They cannot consent to irreversible acts that permanently alter their bodies and prevent them from ever in the future having children.”

After the conclusion of proponent testimony, 16 opponents to HB 1057 spoke to the committee. All 16 opponents are residents of South Dakota, where only one of the proponents was from South Dakota. Opponent testimony included that of medical doctors, psychiatrists and representatives from organizations focused on transgender issues.

“Adolescence is a time of great change both physically and emotionally,” said Dr. Sarah Flynn, a child and adolescent psychiatrist from Avera Health Group in Sioux Falls. “Gender identity formation, and sexual orientation are part of that normal maturation process.”

Flynn continued to discuss what is known about gender dysphoria, the guidelines of care for people with gender dysphoria and her personal experience with patients.

“What I’ve seen with acceptance of person’s gender identity and medical treatment that there is an improvement in their condition,” Flynn said. “Oftentimes they no longer need me and are no longer under the care of psychiatrists for depression or other conditions.”

Additionally, Dr. Michelle Schimelpfenig, a pediatrician for Sanford Health, spoke regarding the role of physicians in medical treatment.

“This bill criminalizes medicine,” Schimelpfenig said. “It is in direct opposition with the policy statements of the American Academy of Pediatrics and other academic societies.”

Schimelpfenig also discussed the training and knowledge one must have to become a medical professional.

“This bill conveys that legislation, not parents and physicians, are best equipped to make those individual and challenging decisions regarding a child’s health,” Schimelpfenig said. “Please don’t let us choose between evidence-based medicine and jail.”

Further opponent testimony by Michaela Seiber, executive board member of the Transformation Project, claimed the sponsor of the HB 1057, Duetsch, has cited invalid research supporting the bill.

“In interviews and on the website devoted to HB 1057, the sponsor claims there’s no scientific evidence to support the use of hormones,” Seiber said. “Had you read the articles he’s relying on in their entirety, he would have realized the researchers did, in fact, find clear scientific evidence to support the use of puberty blockers. … The authors actually recommend beginning puberty suppression when kids first exhibit changes at puberty and urged physicians to have thorough conversations with their patients before beginning hormone therapy.”

The committee meeting, including introduction, testimony and questions from the legislators, lasted just under three hours. The meeting ended with the House Committee on State Affairs passed HB 1057 with an 8-5 vote.

The bill still has several steps to go before it could become South Dakota law.

Since HB 1057 has already been passed by a committee assigned by the House of Representatives, it must now be discussed by the entire House. This vote was initially scheduled for Jan. 24, but was deferred to Jan. 27, where it was deferred again to Jan. 29.

If the vote occurs Jan. 29 and the bill is passed by a simple majority of the 70 representatives, it will move to the Senate, where it will be assigned to another committee. In that committee, they will hear more public testimony. If this committee passes the bill, the Senate will vote.

Should the bill receive a majority vote of both the House and Senate, it will be passed to the desk of Gov. Kristi Noem, where Noem will either sign the bill into law or veto the bill.

If vetoed, a two-thirds vote of the legislature is required to overturn the veto and sign the bill into South Dakota law.